{
  "npi": "1306819735",
  "enumeration_type": "NPI-1",
  "basic": {
    "credential": "PAC",
    "enumeration_date": "2006-02-08",
    "first_name": "JUANITA",
    "last_name": "BRYAN",
    "last_updated": "2018-12-11",
    "middle_name": "E",
    "sex": "F",
    "sole_proprietor": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "6920 POINTE INVERNESS WAY STE 200",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "FORT WAYNE",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "260-479-3520",
      "postal_code": "468047934",
      "state": "IN",
      "telephone_number": "260-479-3513"
    },
    {
      "address_1": "125 E CHERRY ST",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "BLUFFTON",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "46714",
      "state": "IN",
      "telephone_number": "260-824-3500"
    }
  ],
  "taxonomies": [
    {
      "code": "363A00000X",
      "desc": "Physician Assistant",
      "license": "10000231A",
      "primary": true,
      "state": "IN",
      "taxonomy_group": ""
    }
  ],
  "compliance": {
    "oig_leie_exclusion": {
      "excluded": false,
      "status": "CLEAR",
      "matches": [],
      "totalDbRecords": 84224
    },
    "cms_pecos_eligibility": {
      "note": "Not listed in CMS Order & Referring PECOS file or institutional NPI-2"
    }
  },
  "medicare_utilization": null,
  "enrichment": {
    "plain_english_specialty": "Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "97",
        "medicare_type": "Physician Assistant"
      }
    ]
  }
}